QUOTE
As Stanford University’s acclaimed psychologist Albert Bandura declared in a major research review, “alcohol abuse is not a monolithic condition with an inevitable progression” but rather, “a multi-determined pattern” varying from person to person in its severity and causation.
ARTICLES & PRESS
In my practice, 1 out of 6 people would be considered chronic or a severe heavy drinker that experiences dependence. 5 out of 6 either self medicate because of psychological and emotional issues and a lack of coping skills or are on doctor prescribed pain medication for a variety physical and psychologically induced ailments. It is important to differentiate abuse from dependency, they are not the same. The recovery industry refers to dependency as a chronic and progressive brain disease. You will hear people say they are dealing with their substance abuse disease. There is no such thing. A dependent person over time may in fact destroy brain cells and liver function and create a disease state in these organs. But, the behavior is psychologically and emotionally motivated. The dual diagnosis allows doctors to prescribe medication. The alcoholic who attempts to remain sober is allowed his anti-depressant. But, if the primary diagnoses is abuse or dependence and the secondary diagnosis are the co-occurring mental disorders, then the person may have a difficult time recovering. Why? Because the treatment for the primary diagnosis will be abstinence through AA and 12 Step work, and the mental disorders will be masked by prescription medication. But, what about the suffering? What about the underlying issues? You have to be able to assess properly. You have to know where along the continuum they lie. You have to know their severity. You have to think in terms of multi-causal factors. You have to take cultural considerations. You have to determine whether or not they are self medicating or using pain medication to self medicate as well. It is not cut and dry.